NPIMap

Organization Active NPI

Knute Nelson

Doing business as Knute Nelson Hospice

  • Community Based Hospice Care Agency
  • Alexandria, MN
National Provider Identifier
1548517675
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
KNUTE NELSON
Doing business as
Knute Nelson Hospice
Practice address
2715 Highway 29 S
Suite 103
Alexandria, MN 56308-4548
Phone
(320) 759-1270
Fax
(320) 759-1271
NPI assigned
Aug 8, 2012
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marnie Gugisberg
Title
Cfo
Phone
(320) 763-1164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

2715 Highway 29 S
Suite 103
Alexandria, MN 56308-4548

Mailing address

2209 Jefferson St Ste 201
Alexandria, MN 56308-2848
Phone (320) 763-1164

Other names 1

  • Knute Nelson Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000494 MN Part A Provider - Hospice 8123097904 Practice locations: Willmar, MN; Wadena, MN; Alexandria, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548517675. Details of each certification follow.

Hospice certification: CCN 241592

Legal name
KNUTE NELSON
Doing business as
VIVIE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 8, 2013
Last certification
Feb 8, 2019
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Feb 14, 1969 in MN
Enrollment address
2715 Highway 29 S
Ste 103
Alexandria, MN 56308-3470

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Knute Nelson

    dba Knute Nelson Home Health

    • Home Health Agency
    • Alexandria, MN
    • NPI 1477676229

    8123097904

    Same PAC ID
  • Knute Nelson

    dba Knute Nelson Care Center

    • Skilled Nursing Facility
    • Alexandria, MN
    • NPI 1689649790

    8123097904

    Same PAC ID

Care Compare: Hospice

Medicare Care Compare
Listed as
Vivie HospiceCCN 241592 · All quality measures
Ownership
Non-Profit
Certified
May 8, 2013
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Greg Billberg Individual Corporate DirectorDirector Mar 1, 2022
Carol Kraft Individual Corporate DirectorDirector Jan 1, 2024
Katie Perry Individual Corporate OfficerChief Operating Officer Feb 1, 2023
W-2 Managing Employee Jul 24, 2006
Vicki Jodsaas Individual Corporate DirectorDirector Mar 1, 2021
Lisa Dingwall Individual W-2 Managing EmployeeDirector of Hospice Oct 17, 2022
Jeff Montgomery Individual Corporate DirectorDirector Feb 15, 2018
Chad Coauette Individual Corporate DirectorDirector Feb 15, 2017
Fred Semmer Individual Corporate OfficerSecretary/Treasurer Jan 1, 2024
Michael Finn Individual Corporate DirectorDirector Jan 1, 2024
Vivie Organization, Alexandria, MN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2025 100%
Julie Critz Individual Corporate DirectorDirector Mar 1, 2020
Scott Redden Individual Corporate DirectorDirector Jan 1, 2024
Mark Robert Anderson Individual Corporate OfficerPresident and Ceo Dec 28, 2012 100%
W-2 Managing Employee Dec 28, 2012
Phillip Hanson Individual Corporate OfficerChair Jan 1, 2024
Marnie Marie Gugisberg Individual Corporate OfficerSr. VP/Cfo Dec 28, 2012
W-2 Managing EmployeeSr. VP/Cfo Dec 28, 2012
David Steven Wolf Individual Corporate DirectorTreasurer Feb 1, 2015

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Glenwood Village Care Center IncGlenwood, MN, CCN 245402 Skilled nursing facility Operational/Managerial Control (100%) Oct 10, 2022
Hubbard County Heritage Living CenterPark Rapids, MN, CCN 245405 Skilled nursing facility Operational/Managerial Control (100%) Sep 1, 2023
Pelican Valley Health CenterPelican Rapids, MN, CCN 245373 Skilled nursing facility Operational/Managerial Control (100%) Oct 1, 2018
Ethos Home HealthFargo, ND, CCN 357302 Home health agency Operational/Managerial Control Jun 30, 2018
Ethos HospiceFargo, ND, CCN 351517 Hospice Operational/Managerial Control Jun 30, 2018

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 24

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1548517675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 JEFFERSON ST STE 201",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082848",
            "telephone_number": "320-763-1164",
            "fax_number": "320-759-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 HIGHWAY 29 S",
            "address_2": "SUITE 103",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084548",
            "telephone_number": "320-759-1270",
            "fax_number": "320-759-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNUTE NELSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "GUGISBERG",
        "authorized_official_first_name": "MARNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-763-1164"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knute Nelson Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.